Individual
MS. WANDA DENISE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3275 CREEKWAY LN, DECATUR, GA 30034-4909
(404) 243-3865
(404) 243-4368
Mailing address
3275 CREEKWAY LN, DECATUR, GA 30034-4909
(404) 243-3865
(888) 320-1559
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
—
—
174400000X
Specialist
Primary
—
—
211D00000X
Podiatric Assistant
—
—
Other
Enumeration date
06/25/2009
Last updated
02/15/2010
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